• Journal of Environmental Health Sciences
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• v.34 no.2
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• pp.124-130
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• 2008

This study investigated the age dependencies in ambient air pollution-associated asthma hospitalization from 2003 to 2005 in Seoul. For all ages and the age groups of 0-14, 15-64, and 65+years, the Generalized Additive Model (GAM) was used to estimate the relative risks of daily asthma hospitalization associated with changes in particulate matter and ozone. The time-trends, seasonal variances, day effects, temperature, humidity, and pressure at sea level were controlled in the models. Significant associations were observed between asthma hospitalization and the levels of $PM_{10}$ and $O_3$. The relative risks (RRs) of asthma hospitalization for every 10 unit increases in $PM_{10}({\mu}g/m^3)$ and $O_3$(ppb) were 1.008 (95% CI 1.005-1.012), and 1.012 (95% CI 1.003-1.020), respectively. Evaluated over $10\;{\mu}g/m^3$ increase in $PM_{10}$, we found the relative risks of asthma hospitalization to be 1.009 (95% CI 1.004-1.014) in 0-14 age group, and 1.015 (95% CI 1.008-1.022) in 65+ age group. Considering 10 ppb increase in $O_3$, those were 1.014 (95% CI 1.003-1.024) in 0-14 age group, and 1.025 (95% CI 1.009-1.041) in 65+ age group. It was concluded that current levels of ambient air pollution in Seoul make a significant contribution to the variation in daily asthma hospitalization. Further reduction in air pollution is necessary to protect the health of the community, especially that of the higher risky groups including children and elderly population.

• Journal of Environmental Health Sciences
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• v.35 no.1
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• pp.1-10
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• 2009

This study assessed the relationships between levels of $PM_{10}$ and hospitalization rates for asthma among children from 2003 to 2005 at four major cities in Korea. In addition, we estimated the reduced number of asthma hospitalization associated with an ambient $PM_{10}$ improvement to the acceptable levels as recommended by the World Health Organization (WHO). The Generalized Additive Model (GAM) was used to estimate the relative risks (RR) of asthma hospitalization associated with changes in $PM_{10}$ The RRs of children's asthma hospitalization for every $10{\mu}g/m^3$ increment in $PM_{10}$ were 1.009(95% CI = 1.004-1.014) in Seoul, 1.013(95% CI = 1.006-1.021) in Incheon, 1.009(95% CI = 1.002-1.016) in Busan, and 1.021(95% CI = 1.005-1.037) in Ulsan. We assessed $PM_{10}$ related health benefits from implementing the WHO's guidelines (24-hour average $50{\mu}g/m^3$) using the U.S. Environmental Protection Agency's Environmental Benefits Mapping and Analysis Program. The estimated benefits were 439(95% CI = 216-666) reduced asthma hospitalization in Seoul, 720(95% CI = 304-1,151) in Incheon, 260(95% CI = 66-459) in Busan, and 126(95% CI = 30-228) in Ulsan. It was concluded that improving $PM_{10}$ condition to the WHO guideline would make a significant contribution to the reduction in asthma hospitalization among children. Therefore, public health measures are still needed to improve air quality in Korea.

• Journal of Environmental Health Sciences
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• v.36 no.3
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• pp.182-190
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• 2010

We examined the association of particulate matter with an aerodynamic diameter < $10\;{\mu}m$ ($PM_{10}$) with asthma-related hospitalization, stratified by socioeconomic status (SES), among children less than 15 years of age in Seoul, Korea, between 2003 and 2005. In addition, we estimated the reduction in the number of asthma-related hospitalizations that would result from implementing the World Health Organization (WHO) guideline. SES was defined based on data concerning health insurance premium grades, and grouped into two levels: lower-income group and control group. The lower-income group was classified as having an accumulated income which did not exceed the 50th percentile of the median income. Time-series analysis was performed to evaluate the association between $PM_{10}$ and asthma-related hospitalization. The Environmental Benefits Mapping and Analysis Program was used to analyze the impact on children's health. Based upon an increase of $10\;{\mu}g/m^3$ of $PM_{10}$, the asthma-related hospitalization risk for the lower-income group was increased by 1.78% (95% confidence intervals (CI) = 0.79-2.78%), while the risk for the control group was increased by 0.83% (95% CI = 0.34-1.32%). Attaining the WHO guideline, relative to the concentration in 2007, would result in a reduction in asthma-related hospitalizations of 18 cases per 100,000 of the children population in the lower-income group, and 7 cases in the control group. The health benefits of improved air quality for children in the lower-income group were thus 2.5 times greater than for children in the control group. Our results show that the lower-income group is disproportionately burdened with asthma-related hospitalization arising from air pollution. Therefore, biologically- and socioeconomically-disadvantaged populations should be considered in public health interventions in order to protect the children's health.

• The Journal of Internal Korean Medicine
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• v.43 no.5
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• pp.864-873
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• 2022

Objective: The purpose of this case study was to report the symptom improvement effect of integrative Korean medicine treatment based on Pyongsim Solution: Cheonwangbosim-dan in a patient with variant angina and asthma symptoms. Methods: This 68-year-old male patient was treated with Pyongsim Solution, Gamihyangsayukgunja-tang, Gwakhyangjunggi-san, acupuncture, pharmacopuncture, and cupping therapy for 24 days. The European Quality of Life-5 Dimensions-5 Levels profile, Numerical Rating Scale score, and pulse rate per minute were measured on admission, at two weeks of hospitalization, and upon discharge to assess the clinical outcomes. Results: After treatment, the "mobility" dimension profile of the European Quality of Life-5 Dimensions-5 Levels changed from 1 to 1, "self-care" changed from 1 to 1, "usual activity" changed from 3 to 2, "pain/discomfort" changed from 4 to 3, and "anxiety/depression" changed from 3 to 2. The Numerical Rating Scale score for chest pain decreased from 7 to 5, chest tightness decreased from 6 to 4, sleep disturbance decreased from 6 to 3, polydipsia decreased from 5 to 3, and stomach discomfort decreased from 5 to 3. All the profiles of these five dimensions were unchanged for 11 days in the period between the two weeks of hospitalization and discharge. There were also no changes in the profiles of either "mobility" or "self-care" throughout the entire 24-day hospitalization period. Conclusion: This case report shows that integrative Korean medicine treatment based on Pyongsim Solution can improve the symptoms of patients with variant angina and mild intermittent asthma, suggesting that Pyongsim Solution could be an important herbal medication for treatment.

• Journal of Preventive Medicine and Public Health
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• v.36 no.1
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• pp.47-53
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• 2003

Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

• Journal of Korean Academy of Nursing
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• v.44 no.2
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• pp.189-197
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• 2014

Purpose: This study was conducted to develop an asthma management education program for preschool children using Roy's adaptation theory as a framework and examining the effects of this program on adaptation to asthma treatment. Methods: A non-equivalent control group pre-post-test design was used with 43 preschool children diagnosed with asthma and required to be hospitalized for inhalation therapy. An intervention group (n=23) participated in the educational program and a control group (n=20) received regular treatment. The education program was conducted and evaluated from June 30 to October 31 2012, a maximum 3 times every 24 hours during hospitalization. Two nurses conducted the program using the teaching method of Gagn$\acute{e}$ and Briggs; instruction design theory through questionnaires to measure perception of disease, behavior of adaptation to treatment with inhalation therapy. Results: Effects of asthma management education program; scores for face-pain rating decreased and time of adaptation to treatment increased significantly in the experimental group compared to the control group but no significant differences were found for perception of the disease's cause and treatment. Conclusion: Results indicate that the asthma management education program has positive effects on adaptation to asthma treatment of preschoolers.

• Korean journal of aerospace and environmental medicine
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• v.31 no.1
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• pp.17-20
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• 2021

As the coronavirus disease 2019 (COVID-19) pandemic continues, doctors face many difficulties in managing patients with respiratory allergies. As research continues, much new knowledge has emerged about the link between COVID-19 infection and respiratory allergies. Studies to date have shown that there is no significant increase in the risk of COVID-19 infection in patients with respiratory allergies. However, in patients undergoing treatment for moderate to severe asthma or allergic rhinitis, more severe clinical manifestations, increased hospitalization period, and increased mortality may occur, so patients need to be managed with more care. In addition to personal efforts, social consideration should be accompanied to prevent deterioration in patients' quality of life with respiratory allergies due to COVID-19. Lastly, as clinical doctors, we should treat patients with respiratory allergies to protect ourselves appropriately by actively utilizing remote medical treatment and minimizing tests that generate droplets. Also, by appropriately educating patients and continuing drug treatment, efforts should be made to ensure that patients receive the best treatment even in a pandemic situation.

• Environmental Analysis Health and Toxicology
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• v.26
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• pp.11.1-11.6
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• 2011

Objects: The prevalence of asthma has increased in recent decades globally. The objective of the present study is to elucidate whether hospitalization for bronchiolitis in infancy and low socioeconomic status interact for bronchial hyperreactivity during teenage years. Method: We studied 522 children age 13-14 years attending schools in rural and urban areas to investigate the risk factors for bronchial hyperreactivity (BHR), defined as a provocation concentration of methacholine that causes a decrease of 20% ($PC_{20}$) in forced expiratory volume within 1 second. Clinical examination, skin prick test, spirometry, and methacholine challenge were performed on all study subjects, who provided written consent. We used multivariate logistic regression to investigate the risk factors for BHR, and analyze the interaction between hospitalization for bronchiolitis in infancy and low socioeconomic status. Results: Forty-six (10.3%) positive BHR cases were identified. In the multivariate logistic analysis, as independent predictors of BHR, adjusted odds ratio of bronchiolitis diagnosed before 2 years of age in low income families was 13.7 (95% confidence interval, 1.4 to 135.0), compared to reference group, controlling for age, gender, parental allergy history, skin prick test, and environmental tobacco smoke (ETS) exposure. Interaction was observed between bronchiolitis before 2 years old and low socioeconomic status on children's bronchial hyperreactivity (p-interaction=0.025). Conclusions: This study showed that bronchiolitis diagnosed before 2 years of age and low socioeconomic status interacted on children's bronchial hyperreactivity. Prevention of acute respiratory infection in early childhood in low socioeconomic status is important to prevent BHR as a precursor of asthma.

• Journal of Preventive Medicine and Public Health
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• v.39 no.1
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• pp.81-86
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• 2006

Background: A number of studies have reported associations between the ambient air pollution concentrations and various health outcomes. Especially, ozone is well known for primary risk factor of asthma attacks. The results of a recent study indicate that the size of the effect on health outcomes due to air pollution varied according to several conditions, including age, gender, race and the socioeconomic status. Therefore, this study was conducted to examine the associations of ozone with the childhood asthma hospitalizations as stratified by the socioeconomic status (SES) at the community level in Seoul, Korea, 2002. Methods: SES at aggregated levels was measured on the basis of average regional health-insurance rate per citizen in the area. We applied the generalized additive model to analyze the effect of ozone on asthma after controlling for the potential confounding variables that were capable of influencing the results. Results: Our analysis showed that the number of children who were hospitalized for asthma increased as the SES of the residence area decreased. The estimated relative risks of hospitalization for asthma, as stratified by the SES of the community level, were 1.12 (95% confidence interval 1.00-1.25) in districts with the highest SES levels, 1.24 (95% CI=1.08-1.43) within the moderate SES levels, and 1.32 (95% CI=1.11-1.58) in the districts with the lowest SES levels. Conclusions: Our analysis showed that exposure to air pollution did not equally affect the health status of individuals. This suggests that not only the biological-sensitivity markers, but also the SES of the subjects should be considered as potentially confounding factors.

• Clinical and Experimental Pediatrics
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• v.57 no.1
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• pp.29-34
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• 2014

Purpose: In this study, we aimed to investigate the prevalence of year-round respiratory viral infection in children with lower respiratory tract infection (LRTI) and the relationship between respiratory viral infection and allergen sensitization in exacerbating asthma. Methods: We investigated the sources for acute LRTIs in children admitted to our hospital from May 2010 to April 2011. The 6 most common respiratory viruses were isolated from nasopharyngeal aspirate using multiplex reverse transcription-polymerase chain reaction in 309 children; respiratory syncytial virus (RSV), adenovirus (AV), parainfluenza virus (PIV), influenza virus (IFV), human metapneumovirus (hMPV), rhinovirus (RV). Atopic sensitization was defined if more than 1 serum specific Immunoglobulin E level measured using UniCAP (Pharmacia) was over 0.35 IU/mL. Results: RSV was the most common pathogen of bronchiolitis in hospitalized children through the year. RV or IFV infection was more prevalent in asthma exacerbations compared to other LRTIs. AV and hMPV were more likely to cause pneumonia. RV and IFV were associated with asthma exacerbations in children with atopic sensitization, but not in nonatopic children. Conclusion: RV and IFV are associated with hospitalization for asthma exacerbation in children with atopic sensitization.